Forms
Welcome to Hope Psychology Practice. Before you and/or your family join us for our first appointment, we would like to get to know you better. You will receive an email inviting you to create a client portal and complete your intake documents.
If you prefer to complete the intake forms on paper, please complete the following forms and bring them with you to your first appointment. If you have any questions about the information presented in these forms, we can discuss them at the beginning of your appointment.
Child and Adolescent Therapy Forms
- Client Registration Form
- Consent for Treatment
- Billing and Collection Policies or Self Pay Agreement
Adult Therapy Forms
- Client Registration Form
- Consent for Treatment
- Billing and Collection Policies or Self Pay Agreement
Please review the Notice of Privacy Practices form so that you understand how your Protected Health Information (PHI) will be used. This form does not require your signature.
It is often helpful for you or your child’s healthcare providers to collaborate about your plan of care. In order to do so, you must give Hope Psychology Practice, LLC written permission to share your personal information. Please sign a Release of Information form if you would like us to speak with and/or request records from your other providers (e.g., primary care physician, school counselor).
If you have records, such as a report from a previous psychological evaluation or your child’s Individualized Education Plan (IEP), please bring a copy of those records to your first appointment.
